Animal Health Foundation Blog

Grading system helps form prognosis for cats with kidney failure

By Ann Hohenhaus, DVM

An annual visit to your cat’s veterinarian will result in blood tests being submitted to a veterinary laboratory to test for a variety of diseases such as hyperthyroidism and chronic kidney disease. To the typical cat owner, a diagnosis of kidney disease sounds ominous, but it’s not always as bad as it sounds. Take for example my nephew cat BeeDee. He had a rough start in life, abandoned as a kitten at The Animal Medical Center following a head trauma incident. My sister adopted him and he lived a good life, twenty-one years to be exact, despite having been diagnosed with chronic kidney disease at age eighteen.

Kidney disease: The diagnosis

Estimates suggest one to three percent of cats will develop kidney disease during their lifetime and one in twelve geriatric cats has kidney disease. The diagnosis of chronic kidney disease in a cat like BeeDee is based on elevations in two blood tests: blood urea nitrogen, commonly abbreviated BUN, and creatinine plus evaluation of urine-specific gravity. In chronic kidney disease, the urine-specific gravity is neither concentrated nor dilute; it falls in a middle range known as isothenuric because the impaired kidneys no longer have the ability to concentrate or dilute the urine. Creatinine and BUN can be elevated in disorders other than chronic kidney disease such as a kidney infection or dehydration. Taking a urine sample from your cat to his annual examination will win you a gold star from your veterinarian and allow the urine to be tested to determine if chronic kidney disease is likely. For suggestions on how to collect feline urine, click here.

Severity scoring

The International Renal Interest Society (IRIS) developed guidelines to grade the severity of chronic kidney disease in cats and dogs. The IRIS guidelines rank kidney disease from stage I to stage IV as the creatinine increases. Since as many as twenty percent of cats with chronic kidney disease have hypertension, your cat’s veterinarian will recommend blood pressure monitoring. Blood pressure, urine protein level, and organ damage from hypertension all play a role in IRIS staging. As your cat’s stage increases, so does the need for treatment.

A low score wins!

A study of 211 cats with chronic kidney disease, performed at The AMC, showed IRIS stage based only on creatinine levels in the blood correlated with the cat’s longevity. Cats diagnosed with Stage IIb had a creatinine >2.3 mg/dl, stage III greater than 2.8 mg/dl and stage IV greater than 5 mg/dl. Those cats with IRIS stage II kidney disease survived on average over 1000 days, stage III cats nearly 800 days and stage IV cats only about 100 days.

If your cat’s diagnosis is low IRIS stage chronic kidney disease, try not to worry. Treatment can help keep your cat around for years to come. I can’t guarantee your cat will do as well as my nephew cat and live to the ripe old age of 21 – but you never know!

We too are going through this CRF with our lovely little kitty. She needs plenty of good natural foods, vitamins and lots of attention to her water supply, loving time in our laps, massages and did I say loving nurture. Wish the Vet would have stressed the importance of the supplements earlier for the this is hard on the family budget to help her on this journey. It is so special to be able to help this Sweetheart when she needs our help and support.

MY cat has CRF, I used willard water additive in the cats bottled water. Used Milk Thistle herb 200 ml divided into 2 doses daily.. Supplemented with omega 3 with vitamin D, and liquid form Sundown B complex with B 12- 1/2 dropper.
Used cooked eggs, cooked turkey and cooked liver for nutritional value along with canned cat food when she would eat it { Wellness brand} Mix Milk thistle with chicken or turkey baby food. I spent $1000 at vet, tried antibiotics and special diet with slight results. When my cat worsened stopped eating and drinking- I went to natural medicine-Herbs etc My cat is anemic so I have my cat Momma 2 on Pet-Tinic or Pet tab sIron Plus. My cat is doing much better now. Do your own Research- Favorite site littlebigcat.com/health/milk thistle

You wrote that you prepare protein for your cat eggs, turkey, liver) – i was told that cats with kidney failure/disease require diets very low in protein. Were you not given that same information?

i’m feedling my beloved cat food specific to renal failure (Royal Canin). My cat wasn’t eating very much prior to his diagosis (and had lost 1.8 lbs in 15 months). He is eating approximately the same amount and maybe a little more now, which is good since I have heard and been told that some cats don’t like the special low-protein renal failure food. I have already seen a decrease in his urine output after 5 days on the food. My hope is that as his kidneys continue to work less hard to process protein, that he will start eating more and gain back some of the weight he lost.

For me, the most difficult part is feeding my two cats separately, and my older boy, multiple times during the day.

Thank you for explaining more about the protein problem. I’ll have the results tomorrow for my precious boy. We’ve lost one some years back to this so I’m hoping his thyroid medicine just needs adjusting. I can hope. It’s good to know the “whys”.

I adopted a twelve year old part Siamese male cat with stage two renal failure and did not know about raw meat diets until he was stage three. We were both unknowingly exposed to an extreme level of carbon monoxide for a long time and during this time Koko stopped eating and drinking water for 5 days I finally realized that his kidneys were shutting down and jumped on the web to find a solution. The third site visited said that spirulina was excellent for cleaning cats kidneys. I raced to Walmart and got some capsules and a plastic needle less syringe
. Then I mixed some purified water with enough spirulina to make a mixture not to runny or to pasty but something that would leave the syringe and yet not splatter down his throat and into his lungs by squirting the mixture on the side of the roof of his mouth so the tong would wipe it down his throat…and it worked. After doing this 3 times in 4 hours Koko came looking to eat. He put on the weight he had lost although not the muscle at this time he was 18 and still very active. Next I put him on the TC Feline(.com) raw meat chicken diet and he improved amazingly. His fur thickened and became very shinny, he had more energy and his old attitude back….wanna box? I kept giving the spirulina for several months and should not have stopped.